乙型肝炎病毒感染与弥漫大B细胞淋巴瘤的关系研究

Relationship of HBV infection and diffuse large B-cell lymphoma

目的研究乙型肝炎病毒(HBV)感染与弥漫大B细胞淋巴瘤(DLBCL)临床病理特征及预后的关系,对临床治疗提供理论依据。方法选取2005年1月-2010年12月医院收治的160例DLBCL患者为淋巴瘤组,同期其他肿瘤患者160例为其他肿瘤组,160名健康体检者为健康组,比较3组乙型肝炎表面抗原(HBsAg)阳性率,并比较淋巴瘤组患者HBsAg阳性与阴性间各临床病理特征及预后,采用SPSS20.0软件进行统计分析。结果淋巴瘤组患者HBsAg阳性率为22.5%,高于其他肿瘤组9.38%及健康组5.63%,差异均有统计学意义(P<0.05),其他肿瘤组与健康组比较差异无统计学意义;DLBCL患者HBV感染与临床分期、肝脏受累、脾脏受累、ECOG评分有关,差异有统计学意义(P<0.05);HBsAg阳性患者新发肝功能损伤率、完全缓解率及5年存活率分别为29.63%、33.33%及64.71%,阴性患者分别为6.03%、53.23%及81.90%,差异均有统计学意义(P<0.05)。结论 HBV感染可能与DLBCL患者临床病理特征存在相关性,影响患者预后,应加强DLBCL合并HBsAg阳性感染患者抗病毒治疗及肝功能监测。

OBJECTIVE To study the relationship between hepatitis B virus（HBV）infection in diffuse large B-cell lymphoma（DLBCL）patients and clinical pathological features and prognosis,so as to provide basic theory for clinical treatment.METHODSA total of 160 cases of DLBCL patients were selected from our hospital from Jan.2005 to Dec.2010 as lymphoma group,160 cases other cancer patients during the same period as other tumor group,and 160 cases of healthy people as health group.Positive rates of Hepatitis B surface antigen（HBsAg）were compared among three groups.Clinicalpathological features and prognosis between the lymphoma group HBsAg-positive and negative patients were compared.RESULTSThe HBsAg positive rate of lymphoma study group was 22.5%（36/160）,which was higher than that of other tumor group 9.38%（15/160）and health group 5.63%（9/160）,and the differences were significant（P〈0.05）,and the difference had no significant difference between other tumor group and healthy group（P〉0.05）.DLBCL patients was related to clinical stage,liver involvement,spleen involvement,and ECOG score,and the difference was significant（P〈0.05）.The new-onset liver injury rate,complete remission rate,and five-year survival rate of HBsAg positive patients and negative patients were29.63%,33.33%,64.71%and 6.03%,53.23%,81.90%,respectively,and the differences were significant（P〈0.05）.CONCLUSION HBV infection and DLBCL patients clinical pathological features maybe correlated and will affect the prognosis of patients,DLBCL combined HBsAg positive patients should be strengthened with antiviral therapy and liver function monitoring.